Shifting disease patterns and outbreaks affect the recommendations and information we provide to travellers during a pre-travel consultation. Each week Travelvax updates the current travel health alerts to reflect those issues which could affect travellers heading to a particular region or country. We do this by scanning the websites of health agencies such as the World Health Organization and the European and US Centers for Disease Control, as well as international news media. Simply click on the point on the map of your area of interest for more details on the current health alert. We also include Advice for Travellers which gives background information and tips. If you have any further questions, of course you can give our Travelvax infoline a call during business hours on 1300 360 164.
World travel health alerts for 8th of February 2023
2022 arbovirus report card
A PAHO epidemiological update published on Jan 23 that covered 2022 data on dengue, chikungunya and Zika virus in the region called for countries ‘to remain vigilant about the possibility of an increase in chikungunya cases, given the accumulation of susceptible people 8 years after the major outbreak of this disease in 2014’. Brazil topped the count for suspected cases of all three diseases over the year, while Nicaragua and Peru rounded out the top three places for dengue fever. Elsewhere, a news source in Argentina summarised recent reports on locally-acquired dengue fever cases (in the City of Buenos Aires, Córdoba, Tucumán, Salta and Santa Fes) and chikungunya infections, most of which were imported (contracted in Paraguay or Brazil). Read more
Advice for travellers
Dengue is spread by Aedes mosquitoes which breed in shady areas close to habitations and bite mainly during the daylight hours, making them difficult to avoid outdoors. Travellers should cover up with long-sleeved tops, long pants, and shoes and socks when mosquitoes are most active. Apply an effective repellent containing an active ingredient, such as DEET, Picaridin, or oil of lemon eucalyptus (PMD) when outdoors to all exposed skin. Read more about dengue fever.
Flu season monitoring
The ECDC influenza update for the last full week of January noted ‘substantial seasonal influenza virus circulation across the Region’, with high rates of testing positivity in Armenia, Bulgaria, France, Moldova, Slovenia and Switzerland. Influenza A(H1)pdm09 viruses were predominant, however the overall intensity of infections is now decreasing. Read more
Advice for travellers
In most years, seasonal flu is the most common vaccine-preventable travel-related illness: it’s likely to be found aboard aircraft, in crowded airport terminals, and at your destination. Vaccination is highly recommended and travellers should also avoid close contact with people showing flu-like symptoms, and thoroughly washing hands using soap and water after using the toilet and before eating. Alcohol wipes are a convenient alternative if soap and water is not available. Read more
COVID-19 update
The WHO will be moving to 4-weekly COVID-19 reporting intervals as it will provide a more accurate view of infection and mortality trends across the globe - its dashboard is still updated weekly. In the latest epidemiological report, the agency provided an outline of the most prevalent variants across the regions: BA.5.2 in the Western Pacific; XBB.1 in SE Asia and the Eastern Mediterranean; and BQ.1 and BQ.1.1 (descendant lineages of BA.5) in Europe, the Americas and Africa. Read more. Today (Feb 8), the Australian health department outlined ATAGI’s recommendations for a booster COVID-19 vaccine dose and the rationale behind the decision. Read more
Mosquito warnings in 2 states
A second person has contracted Japanese encephalitis (JE) since the November start of the mosquito season in Victoria – the infection dates from early last month and, according to the health department, timing suggests it could have been contracted in either Buloke Shire or Swan Hill. Health.vic has also alerted residents and visitors to the presence of Murray Valley encephalitis virus (MVEV) in mosquitoes in the state’s north, saying it posed ‘a significant risk to people in these areas, particularly Mildura and northern Victoria’s inland river regions’. In related news, NSW Health warned late last week that ‘MVE virus has been detected in mosquitoes across a wide area of western and southern NSW’ and advised people in the affected areas ‘to avoid being bitten by mosquitoes, which are most active between dusk and dawn’. Read more
Advice for travellers
A mosquito-borne virus, JE is usually found in many part of Asia, the Indian subcontinent, Southeast Asia and China, although cases also occur in Indonesia and PNG, and now parts of Australia. It is mainly found in rural areas around rice paddies where pigs, wading birds and humans live closely together, however it does also occur in or near cities. The risk to short-stay travellers who confine their travel to urban centres and use appropriate mosquito bite avoidance measures is low. The recommendations for vaccination are itinerary-specific. Read more on JE.
More Nipah virus cases, deaths
The Institute of Epidemiology, Disease Control, and Research has announced two more Nipah virus (NiV) cases and two deaths, taking the case count to 10 and the death toll to seven - a marked increase on the combined totals for 2021 and 2022 (five cases in all). Infections have been recorded in six districts located mostly in the country’s central and western regions, however the institute stated that the risk of NiV is present countrywide. The community has been reminded not to drink raw date palm juice and to avoid fruits partially eaten by bats, the virus reservoir. Read more
Advice for travellers
Fruit bats are the natural hosts of Nipah virus, and females shed the virus when pregnant or lactating. The fruit-eating bats perch on the jars used for collecting juice from palm or date trees, contaminating the juice with infected saliva and droppings. People are infected when they drink the raw juice, although it is also spread through person-to-person contact. In Bangladesh, Nipah generally occurs between December and April. Read more on Nipah virus
Global polio digest
A single case of circulating vaccine-derived poliovirus type 2 (cVDPV2) was registered in Aceh and reported to the GPEI last week – Indonesia’s first in 2023. All other notifications were cases dating from 2022: seven in Chad (Mandoul, Chari Baguirmi, N’Djamena, Batha and Guera), and the remainder consisted of one cVDPV2 case each in Central African Republic (Region Sanitaire 3), Nigeria (Sokoto) and Yemen (Sanaa City). Read more
Advice for travellers
Polio is a potentially serious viral illness that is spread through contact with infected faeces or saliva. The risk to travellers is generally low, however vaccination is recommended for travel to affected regions and is a requirement for travel to/from some countries. If at risk, adults should have a booster to the childhood series. More on poliomyelitis.
Scrub typhus in south
A report posted last week in ProMED has drawn attention to scrub typhus infections acquired in Los Lagos region – instead of the usual one to two cases detected in the month of January in most years, 12 suspected cases (10 since confirmed, two pending) were notified in a 2-week period. The Chilean Rickettsia and Zoonosis Research Group advised that the infection ‘is endemic over a wide geographical range in southern Chile (from Biobío Region in the North to Tierra del Fuego in the South’. It is acquired through the bites of infected chiggers or mites during outdoor activities so presents a risk for both locals and tourists. Read more
Advice for travellers
Scrub typhus is a bacterial disease passed on to humans by mites that normally live on rodents infected with the disease. Most travel-acquired cases occur when travellers camp, hike, or go river rafting in rural areas in endemic countries. Scrub typhus occurs throughout the Asia-Pacific region, where more than a million cases occur annually. There is no vaccine or prevention medication: avoidance hinges on minimising insect bites. Due to the disease’s 5- to 14-day incubation period, travellers often experience symptoms (fever, headache, malaise, and sometimes nausea, vomiting and a rash) after their trip. Read more about rickettsial diseases
Regional mpox risk ‘high’
New global mpox cases have declined substantially since the peak in August last year, however the WHO continues to assess the risk in the Americas as high. The region recorded almost 90 percent of all new infections in the past month and the highest increase in the latest reporting week was in Mexico. In Africa, 81 mpox cases have been recorded this year - 12 in Nigeria and the remaining 69 from the regions of Maniema, Sankuru and Tshuapa in the D R of Congo. Read more
Advice for travellers
Closely related to the smallpox virus, mpox (monkeypox) was mainly found in Central and Western Africa. Rodents are the suspected reservoir, with monkeys and humans as secondary or ‘spill-over’ hosts. People can be infected by eating undercooked ‘bushmeat’ or handling infected animals, making infection a low risk for travellers. More information on the 2022 global outbreak of monkeypox from the WHO. Read more on monkeypox.
Cholera cases increasing in NE
The weekly WHO regional bulletin gave an account of a rapidly expanding cholera outbreak affecting a number of camps for internally displaced populations (IDPs) in Nord Kivu province. Nyiragongo health zone has recorded the majority of new cholera infections, however Karisimbi is also affected. Many cases are not being detected early, leading to more moderate or severe symptoms among the ill. The agency notes ‘a major risk of spread to neighbouring countries considering population movements between DRC and Rwanda or Uganda’. Read more
Advice for travellers
Cholera is usually spread in contaminated water. For most short-stay travellers, the risk of infection is low. Australians travelling to regions where a cholera outbreak is occurring should adhere to strict personal hygiene guidelines and choose food and beverages with care. Read more about cholera.
Diphtheria cases in Enriquillo Region
Two separate diphtheria clusters have been reported in the SW provinces of Barahona and Independencia, with at least four children admitted to local hospitals; one young child has succumbed to the infection. Read more
Advice for travellers
Spread by coughing and sneezing or by direct contact with wounds or items soiled by infected persons, diphtheria is one of the infectious diseases prevented through routine childhood vaccination. It is also a component in the vaccine given to pregnant women for the prevention of pertussis. Read more on diphtheria.
Measles count tops 440
The NICD provided its last measles outbreak update on Feb 2: 441 measles infections had been confirmed to the week ending Jan 28 and test positivity had started to climb again. Since the update was posted, a local news source reported that five measles cases had been detected in Western Cape province. In related news, health authorities in Ghana have announced an outbreak of measles in Northern Region which has sickened at least 70 children since October. Read more
Advice for travellers
Measles occurs in developing and developed countries and unvaccinated travellers are at particular risk, both in transit and during their stay. While generally benign, infection can result in severe illness or death. Travelvax Australia recommends travellers check their immunisation status for measles and other childhood diseases such as diphtheria, whooping cough (pertussis) and mumps at least 6 weeks before departure. Read more about measles.
NTD target reached
Ghana is the latest African country to eliminate human African trypanosomiasis (HAT or sleeping sickness) as a public health problem. HAT is just one of the 20 diseases and disease groups of neglected tropical diseases (NTDs) marked for prevention, control, elimination or eradication by 2030. Read more
Advice for travellers
Human African trypanosomiasis (HAT) is rare in travellers, however the tsetse fly, which spreads the disease, is found in 37 African countries. The aggressive flies are attracted to moving vehicles and bright, dark colours and are not deterred by insect repellents. As the flies can bite through light-weight clothing, travellers should cover up with medium-weight fabrics and apply a personal insect repellent containing DEET (30-50%), Picaridin, or oil of lemon eucalyptus (PMD) at all times when outdoors (for the prevention of other insect-borne diseases). Read more on HAT and how to avoid infection.
Ouest department most affected in cholera outbreak
An update on the cholera outbreak published this week by the PAHO advised that it had reports of nearly 29,000 suspected cases from all 10 departments, with just over half of cases in Ouest (in particular Port-au-Prince, Delmas, Cité Soleil, Carrefour and Pétion-Ville). The agency announced that in late January the WHO and its regional offices ‘took the unanimous decision to label the current Global Cholera situation as a Grade 3 multi-region Public Health Emergency, which is the highest level of institutional priority assigned a public health event’ – the decision was reached in view of ‘the current scale of the ongoing cholera outbreaks’. Read more
Advice for travellers
While the risk of infection with cholera is low for short-stay travellers, Australians travelling to regions where an outbreak is occurring should adhere to strict personal hygiene and choose food and beverages with care. Read more about cholera.
Lassa fever situation deteriorates
The government said it raised the emergency response rating for Lassa fever in view of three factors: ‘an unprecedented upward trend in the number of confirmed cases’, more states implicated and more deaths and infections among healthcare workers. The majority of cases since November have been in Ondo and Edo, however confirmed cases have been reported from 16 states and the FCT. Read more
Advice for travellers
Lassa fever is an acute viral illness that occurs in West Africa, notably in Nigeria, Guinea, and Liberia. As many as 300,000 cases and 5000 deaths occur each year. However, Lassa is a remote risk for travellers. Rodents shed the virus in urine and droppings and it is spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person. Read more about Lassa fever.
Northern district reports cholera
A second district has reported cholera cases – the latest is Mwansabombwe in the northern province of Luapula, where at least seven infections have been detected since Jan 26. The other outbreak in Vubwi District of Eastern province continues, with the case count rising to 42. The death toll remains at one. Read more
Advice for travellers
While the risk of infection with cholera is low for short-stay travellers, Australians travelling to regions where an outbreak is occurring should adhere to strict personal hygiene and choose food and beverages with care. Read more about cholera.